A&P OU BOCES PNP > Chapter 19- Urinary System > Flashcards

Chapter 19- Urinary System Flashcards

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1
Q

urinary system

A

kidneys, ureters, urinary bladder, and urethra

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2
Q

Kidneys

A

right and left

surrounded by fibrous connective tissue-supportive function

major organs of the this system r/t need to eliminate toxins from the blood/regulate fluid volume/assist with levels of K and Na/adjust level of pH, this allows allows for control of BP/RBC production

Is part of the GU system r/t right and left ureters/nerves and blood vessels for transport of gasses

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3
Q

retroperitoneal

A

situated or occurring behind the peritoneum
lines the abdominal cavity—protective function for the renal system

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4
Q

What will the GU system excrete/eliminate?

A

waste products from the body

metabolic waste products—meds/hormones/H20

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5
Q

Metabolic waste products

A

substances from cellular metabolism
cells convert nutrients into waste products
leftover products need to be eliminated from the body via the renal system

Ex: urea/cr/CO2/H20/lactic acid from muscles/ammonia from proteins/salts—Na/K/Ca

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6
Q

if the metabolic waste products are not eliminated, _________ __________ will occur

A

renal failure

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7
Q

Where are the kidneys located in the body?

A

12th rib level or near the T12 and L3 vertebra

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8
Q

hilum

A

located in the central area of the right and left kidneys
allows for renal artery/renal vein/right and left ureters to enter and exit the kidney renal artery—oxygenated blood/renal veins—deoxygenated blood ureter—eliminates urine

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9
Q

renal cortex

A

outer aspect of the kidney
allows for the production of urine

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10
Q

renal medulla

A

inner region
allows for urine collection—-works with the GU system for “holding” of urine

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11
Q

renal columns

A

divide the interior kidneys and allows for the cone-shaped appearance/supportive function—allows the kidneys to have structure

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12
Q

renal pyramids

A

base of each pyramid faces outward toward the cortex
contains tubules for transport of urine
also will concentrate urine/allows for fluid reabsorption
all this is necessary for blood pressure management

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13
Q

renal papilla

A

faces the hilum
allows for the collection then drainage of urine in the renal collection system

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14
Q

minor calyx

A

collects urine leaving the papilla.
Two or three minor calyces join major calyx—2-3 minor calyx—”transition” point for the urine collection
directs urine to the renal pelvis

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15
Q

Renal pelvis

A

the central region of the kidneys
collects the urine for transportation/flow to the ureters

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16
Q

The major calyces converge to form the _________ __________, which receives urine from the major calyces. The renal pelvis continues as the ureter, which channels urine to the urinary bladder.

A

renal pelvis

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17
Q

Blood vessels, nerves, and the ureter enter and leave the kidney from the:
A. renal pelvis.
B. hilum.
C. calyx.
D. renal pyramid.

A

Correct answer: B
Rationale:
The renal pelvis, formed by the convergence of the major calyces, channels urine out of the kidney.
The calyx collects urine leaving the papilla.
Renal pyramids are the cone-shaped sections in the kidney.

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18
Q

What do kidneys need?

A

oxygenated blood

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19
Q

renal artery

A

(branches off the abdominal aorta)
brings blood to the kidneys
this artery will branch into smaller arteries
arteries pass through the renal columns/ into the renal cortex/will then leave the kidneys via the renal vein

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20
Q

Renal vein

A

allows for deoxygenated blood to empty in the inferior vena cava

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21
Q

Nephrons

A

the filtration units of the kidney
need a constant flow of blood. (More than 20% of the blood pumped by the heart each minute goes to the kidneys.)

the filtration units of the kidneys/all nephrons contain blood
outer region (the cortex) filters the waste products from the blood/basically in the form of urine—recall the process of filtration

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22
Q

afferent arterioles

A

From smaller arteries in the cortex
each afferent arteriole supplies blood to one nephron

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23
Q

glomerulus

A

this is the where the afferent arterioles become capillaries

this is a “cluster” of capillaries”—-capillaries allow or exchange of nutrients and waste products

necessary for blood flow/maintains fluid and electrolyte balance in the body

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24
Q

GFR

A

glomerular filtration rate—rate of blood filtration

rate in which the kidneys filter the waste products from the blood

indicates healthy vs unhealthy renal function (renal failure)

measurement of renal function’s ability to filter waste products for removal from body/uses concept of filtration and pressure gradient (highest to lowest concentration) for blood flow from the glomerulus to the bowman’s capsule
wnl—60 mL per min or >
< 60 x 3 months-renal ds
< 15—renal failure—think HD or transplant

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25
efferent arterioles
allows blood to exit the glomerulus
26
peritubular capillaries
capillaries (from the efferent arterioles) reabsorb H20/nutrients/minerals from the renal tubules back into the blood stream/will also allow for the secretion of waste products in to the renal tubules—allows for elimination of waste products in the urine Eventually the peritubular capillaries will drain into larger veins that will drain in to the renal vein and the inferior vena cava
27
Renal innervation
NS works with the renal system afferent/efferent arterioles---this allows for control of the blood vessels r/t need for regulation/rate of urine formation hypotension-NS will allow release of Renin (enzyme) to regulate BP thru process constriction (diameter of the blood vessels constrict to decrease blood flow
28
renal corpuscle
beginning of the nephron filters the blood includes the glomerulus---cluster of capillaries and the bowmans’s capsule-first step of urine formation/collects the filtered blood to from urine
29
renal tubule
tube like structures where urine is formed divided into four regions proximal convoluted tubule—starts near the bowman’s capsule contains microvilli---this is a group of epitheal cells that “expand” the surface area of the renal system to allow for reabsorption of H20/nutrients/glucose/electrolytes/amino acids (previous learning)—this allows for overall homeostasis
30
nephron loop
loop of henle also an area of filtering of blood to begin urine formation/maintain fluid and electrolyte balances descending loop---H20 absorption via osmosis---osmolarity of urine (concentration of urine) ascending loop----reabsorbs Na/chloride/concentration of Na
31
distal convoluted tubule
regulates extracellular fluid volume in the body/Na, Ca, K, hydrogen/---dependent on hormones---aldosterone
32
collection duct
leads to the monior calyx for urine collection
33
What are the filtration units of the kidney? A. Renal corpuscle B. Glomerulus C. Nephron D. Renal pelvis
Correct answer: C Rationale: The renal corpuscle is part of the nephron. The renal corpuscle contains the glomerulus. The renal pelvis funnels urine out of the kidney.
34
What three processes does urine formation involve?
Glomerular filtration Tubular reabsorption Tubular secretion
35
glomerular capillaries
H20/ electrolytes/ glucose/ amino acids/nitrogen waste products filter out of the blood and into Bowman’s capsule (small enough particles to filter thru the capillaries) (Blood cells/most plasma proteins are too large to pass through this part of the renal system.)
36
What is the average person's GFR?
180 L per day (60 x body’s total blood volume.)
37
The body reabsorbs about _______ of this filtrate, leaving ______________ to be excreted as urine
99% 1 to 2 L
38
Recall
proteins require selective permability for transports
39
proteinuria
protein filters and is excreted in the urine---renal ds
40
Atherosclerosis
occurs in the renal artery---HTN affects the renal system
41
Glomerular filtration rate (G F R) should be ___________, despite _________ in blood pressure
constant changes Rate should be consistant---allows for fluid and electrolyte levels to remain wnl
42
If GMR flow is too high, what will the body do?
lose excessive water and nutrients
43
If GMR flow is too low, what will the body do?
tubules may reabsorb toxins
44
Recall concept of vessel resistance
ability to constrict and dilation (afferent arterioles)
45
RAAS
renin-angiotensin-aldosterone system-maintenance of BP and GFR
46
Juxtaglomerular cells
located in the afferent arterioles release renin
47
renin
an enzyme for the renal system becomes the enzyme angiotensinogen 1 (made in the liver)
48
Aldosterone
this is a steroid hormone produced by the adrenal glands
49
What is the order of events in the RAAS?
1. A decline in blood pressure leads to decreased blood flow to the kidneys. Juxtaglomerular cells-located in the afferent arterioles 2. release: renin-an enzyme for the renal system 3. renin- becomes the enzyme angiotensinogen 1 (made in the liver) i 4. Angiotensin I circulates to the lungs- to meet with the angiotensin-converting enzyme (ACE)—will then become angiotensin II. 5. Angiotensin II stimulates the adrenal glands to secrete aldosterone (this is a steroid hormone produced by the adrenal glands) 6. Aldosterone; causes the distal convoluted tubule to retain sodium H2O follows Na- leads to increased retention of H20=increased BP r/t increased volume of fluid in the body
50
tubular reabsorption
chemicals are reabsorbed in the renal tubules and returned to the blood circulation (electrolytes/glucose/amino acids
51
tubular secretion
allows for the removal of waste products from the body--- ammonia, uric acid, H, K, meds (PCN and ASA), Hydrogen---allows for pH balance, waste products Requires active transport (energy)
52
Most sodium is reabsorbed from the glomerular filtrate in the: A. proximal convoluted tubule. B. distal convoluted tubule. C. collection duct. D. glomerulus.
Correct answer: A Rationale: The distal convoluted tubule and collection ducts reabsorb variable amounts of water and salt. In the glomerulus, water and small solutes filter out of the blood and into Bowman’s capsule.
53
What are some hormones that affect the Urinary System?
Aldosterone, ANP, and PTH all act on the renal tubules ADH acts primarily on the collecting duct Aldosterone---secreted by the renal cortex activates when blood levels of Na+ decline or K levels increase allows for reabsorption of NaCh and H20 to increase BP to pt's baseline ANP— secreted by the atria of the heart r/t HTN inhibits the secretion of aldosterone and ADH allows renal system to eliminate NaCl and H20 will decrease BP so HTN resolves---pt returns to baseline BP ADH- secreted by the posterior pituitary gland reabsorbs H20 will increase BP for pt who is hypotensive PTH: secreted by the parathyroid glands r/t hypocalcemia--low calcium levels needed for calcium homeostasis: avoid renal stones/calcium deposits in the cardiac muscle
54
What is the composition of urine?
Consists of 95% water; 5% dissolved substances Reveals information about health of kidneys and other organs
55
BUN levels
dissolved nitrogenous wastes—( urea, uric acid, ammonia, Cr) Na/K/ sulfates (anion---electrolytes/minerals that regulate BP)
56
Anion gap
used in acute exacerbation of a chronic ds such as DM necessary for ability of the renal system to excrete acid maintain acid base balance
57
ureters and urethra
conducts urine away from the kidneys and out of the body---voiding
58
bladder
stores urine until person is able to void
59
detrusor muscle
wall of the bladder 3 layers of smooth muscle/allows for bladder filling
60
rugae
relaxed bladder
61
trigone
location of the 2 ureters and urethra UTI—> in female gender r/t short urethra
62
internal urethral sphincter
ring of smooth muscle/ contracts involuntarily to retain urine in the bladder.
63
external urinary sphincter
skeletal muscle/ voluntary control.
64
external urinary meatus
opening for elimination of urine
65
Male-GU and reproductive system
contains urine and sperm urethra conveys both urine and semen
66
What is the process of urination?
1. Stretch receptors send impulses to spinal cord. 2. Spinal cord sends motor impulses to bladder. 3. Pons can override impulses. 4. The brain sends signals to contract or relax sphincters.
67
What happens when you need to urinate?
-200 -400mL or more of urine/stretch receptors in the bladder wall send impulses to the sacral region of the spinal cord---injury from paralysis/infection will affect this area---possible incontince-leads to necessity of good nursing skills/care
68
The triangular-shaped smooth area on the floor of the bladder is called the: A. rugae. B. papilla. C. cortex. D. trigone.
Correct answer: D Rationale: Rugae are folds of tissue on the inside of the bladder. Papillae are the blunt points of the renal pyramids. The cortex is the outer zone of the kidney.
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